Hi All,
I have to get in on this thread.  So here goes:

I just watched a video of Sandra Lang done in 1995 (I believe).  It is an
ILCA video.

In this video she goes into great detail about cupfeeding in the neonatal
unit, and shows, via video, how preterm infants CAN lap milk out of a cup.
As I watched this tape, a 33 wk old bb was lapping the milk.  Out would come
this little tongue and into the milk it would go!  It was amazing.  If that
wasn't lapping I don't know what is.

As far as aspiration, silent or otherwise, it does not happen if the baby is
being cupfed properly.  The feed MUST be baby led, not adult led.  The milk
must NEVER be poured into the baby's mouth.  The cup is placed at the upper
outer corners of the top lip and the milk is placed (by tipping the cup)
just touching the bottom lip.  At no time does the person feeding the baby
put the milk any farther than the lip.  The baby takes in the milk (by
lapping) at his/her own pace and is in control of the feed and how much milk
s/he gets.

OK, now to comment on a couple of things:

It was written:
>>To tell you the truth, Iam personally getting a little tired of the whole
subject.<
The response:
>That doesn't resolve anything.

You know what?  The response here, IMHO, was a tad rude.  There was really
no need for the reply.  I am getting tired of the tone this topic has taken
at times.  It sounds more like an argument than a question answer discussion.

Next:

>>I would like to point out that, according to some of Geoff's posts,
thetheory also seems to state that babies younger than 4 months cannot lap
up milk from a cup.  This is patently false as many of us have witnessed in
real life, not in theory. <

>I suggest you check your infant development just a little closer.  Casual
observation does not prove anything.  An infant does not *lap* The response
is suckle and the point is far from moot.

Geoff, if I remember correctly, Jack Newman wrote this, and I think he knows
an awful lot about infant development.  :)  Also, a lot of us have seen
babies of various ages who have no "suck" response for a variety of reasons.
We work with these babies as best we can to stimulate a suck response, and
sometimes the only thing we get is a "lap" from a cup, and if that is not
possible the poor kid gets a tube down its throat for a feed.

Next:

> Flaming me  *I am personally getting a little tired of the whole subject.*
doen't
>answer the question.

If you think this is a flame, you have never been flamed!  :) Now, if
someone said "Jay Simpson is a stupid jerk, and is a real poopey-head", that
is a flame (even if it might be true :D )  A flame is a personal attack, and
we have rarely had those on Lactnet, unlike other active lists.

Just a note:

>O2 sats have been found to be a screening tool only when matched against
>direct observation.

Sandra Lang found that babies who were bot fed (and these babies were on
moniters) that the moniters went off because the babies were having a hard
time.  They were not in control of the feed.  However, the babies who were
cup fed did not have their moniters going off.  Why?  Because they were in
control.  Their 02 sats stayed stable and so did their cardiac rates.

Geoff writes:
>Without new evidence, documented proof, the present standards have to be
>followed until proven different.

WHY?  If someone finds something that works better than the standard, why
stick with something less than acceptable?  Not all proof is documented for
a variety of reasons.  Granted, new ideas need to be brought to light,
tested, studied etc, but to stick with some practice simply because it is
standard is, IMHO, silly, and can be deadly.  Sticking to "standards of
practice" is one main reason why BF babies are being given formula for
jaundice, formula if mom takes a medication a /dr didn't bother to check out
for AAP approval w/BF, formula is still being touted as "as good as
breastmilk" by many MD's and Ped's all over the world.  It is also a reason
why moms with babies allergic to dairy are told to wean and feed soy formula
rather than to take the dairy out of their own diet and save the BF.
Standards of practice have cost many mothers and babies a BF relationship,
and all the benefits, simply because some Dr didn't want to do something a
little different, try something new, and do whatever s/he could to help save
the BF.  I have seen it far too many times, and it is pathetic.

Jack wrote:
>We *could* help support breastfeeding mothers, LC's, physicians andOT's,
but I only wish OT's spent as much time studying breastfeeding as they do
bottle feeding.  And even spent half the time helping mothers and babies to
breastfeed as they do helping them to bottle feed.<

Geoff responded:

>Please provide some accepted measure to back this statement.  It is pure
>anecdote and wholly incorrect where I practice. Therapy centers on the
>mother's wishes, not what the therapist wants.

This may be incorrect where you practice, but then you are the lucky one if
your statement is followed by everyone in your practice.  It is high time
that a mother's wishes come first, or at least are considered, with ALL
health professionals.  However, for the majority of us, trying to find an OT
who has a clue about BF is a difficult task indeed, and sometimes
impossible.  We have an oral surgeon (with a degree in speech therapy) here
who finally decided that frenotomies were important for the newborn (who
could not BF bc of a short/tight frenulum) because her newborn had a short
frenulum, she wanted to BF and found she had many problems.  Clip the
frenulum and guess what?  No more problems.  She is now talking with all her
colleagues about this trying to spread the word that frenotomies are
important and that sacrificing the BF "because youcan always bottle feed" is
not acceptable.
I personally feel that anyone who works with babies should be educated (if
even just the basic "do whatever neccessary to save BF") in bf and its
importance in all areas of infant/child development.  That includes, oral
cavity, motor, educational, moral, emotional, health, etc.  BF is important
for a babies entire system of development.
No "backing" of Jack's statement is needed because we have to fight for MD's
to have a clue about BF, so why not every other medical profession?  I have
yet to meet one OT who can correctly describe where the breast should be in
the babies mouth, and why.  But, then again, I don't know many MD's here who
can do that AND we are still fighting for Drs to stop telling moms they
can't BF while taking Tylenol.  Sigh...

IMO, the entire medical establishment MUST stop with the "formula is just
fine and so is bottle feeding" garbage.  It is not fine, bottle feeding is
not fine...BF is what moms and babies were designed to do.  BF is why
breasts were put on a womans body in the first place.  The med establishment
needs to haul their heinies out of the formula companies back pocket and
focus on the mom and baby, not the new hospital wing with the nursery and
maternity wards on different floors.

OK.  End of rant.
Jay Simpson, CLE
Sacramento, CA
Mama Milk is the Greatest!